COVID-19: Antibody+ survivors at the vanguard after April 30 end of social distancing?

Dr. Daniel Lucey, who has responded to, and monitored information on outbreaks since 2001, has provided a series of updates and analysis on what is now the COVID-19 pandemic in Science Speaks posts first published Jan. 7. This is his 17th update on questions raised by the continued spread of, and responses to the virus that causes COVID-19.

On Sunday, President Trump announced at his Rose Garden press conference that the federal social distancing guidelines for COVID-19 would be extended through April 30. The potential for a total of 100,000 deaths in the USA due to COVID-19 was presented, as well as the estimated peak of deaths occurring two weeks from now (14 days from now will be Sunday, April 12). As of this evening 2,400 COVID-19 deaths have been reported in the United States.

At the Sunday press conference, President Trump also suggested that more updated information on US guidelines would be provided by this coming Tuesday evening, March 31.

This is what we envision: Our expanded testing capabilities will quickly enable us to publish criteria, developed in close coordination with the Nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus. This will incorporate robust surveillance testing, which allows us to monitor the spread of the virus throughout the country. Under these data-driven criteria we will suggest guidelines categorizing counties as high-risk, medium-risk, or low risk.

In my opinion, we can anticipate further information on Tuesday, March 31 from the White House on these “guidelines categorizing counties as high-risk, medium-risk, or low risk.”

Also on March 29, a worth-reading 16-page document was posted by the American Enterprise Institute titled “National Coronavirus Response: A Roadmap to Reopening.” This detailed roadmap might be among the multiple documents under consideration before the announcement by the White House Tuesday, March 31 on updated US guidelines.

The additional time between March 29 and April 30 provides multiple opportunities. Of those, one that perhaps warrants even earlier emphasis than given in the above AEI 16-page document, is whether presumably “immune survivors” of COVID-19 who have recovered and have a positive IgG antibody response against the SARS-CoV-2 virus, could serve on the vanguard of initial persons helping to reopen the US economy after April 30th?

If so, then they would still need to be observed closely to be sure they indeed are immune to re-infection. I would be reluctant, or at least very slow initially, to recommend that frontline workers who are antibody-positive against the SARS-CoV-2 virus should not wear COVID-19 personal protective equipment.

A crucial scientific issue is how accurate is the particular antibody test for any given individual? Would the antibody test be one developed by the US CDC and if so, would it be widely available across the USA before April 30? If not a US CDC antibody test, then how comparable are different antibody tests?

In addition, some type of verification of a standardized test for antibody-positivity will be necessary. Could this be a COVID-19 Antibody-positive verification card (‘don’t leave home without it’). Or perhaps a QR code for antibody-positive (presumed) “immune survivor”? More information can be anticipated this Tuesday, March 31, and before and after April 30.

Daniel Lucey, M.D. MPH, FIDSA, FACP, is an infectious diseases physician and adjunct professor of infectious diseases at Georgetown University Medical Center, a senior scholar at the Georgetown University O’Neil Institute, Anthropology Research Associate, Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee.He has served as a volunteer medical responder to outbreaks that included the West Africa Ebola crisis. He has collected information on outbreaks starting in 2001 with cases of anthrax in 2001, and including smallpox vaccination 2002, SARS 2003, H5N1 Flu 2004, MERS in 2013, and Ebola in April, 2014, He has gathered, and updated information on the spread of the coronavirus Jan. 6.